Es (HCS), Texas Home Living (TxHmL) and Deaf Blind with Multiple Disabilities (DBMD) Programs Note: This form must be faxed to Waiver Survey and Certification by the end of the next business day following the death or the program provider s learning of the death. To: Waiver Survey and Certification Attn: Risk Assessment Coordinators Fax No.: 512-438-4148 Provider Name Contract No. Date Submitted to DADS Comp Code (HCS & TxHmL) Submitted by Area Code and Telephone No. Contact Area Code.
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How to fill out the Form 8493 online
This guide provides a comprehensive walkthrough for users on how to fill out the Form 8493 online. The form serves as a notification to the Texas Department of Aging and Disability Services regarding a death in specific community-based services programs.
Follow the steps to complete the form effectively.
- Click 'Get Form' button to obtain the form and open it in the editor for completion.
- In the first section, provide the name of the provider and their contract number. Ensure all details are accurate to avoid delays in processing.
- Enter the date the form is submitted to DADS. This should reflect the actual submission date to ensure timely communication.
- Complete the 'Comp Code' field for HCS & TxHmL programs as applicable, ensuring it aligns with departmental requirements.
- Fill in the submitted by section, listing the contact name, area code, telephone number, as well as fax number as needed.
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